No abstract available.
Frontal Sinus*

Six cases of a rare variant of endocervieal adenocarcinoma (Adenoma maligum, AM) were collected for clinicopethologic analysis. The everage age of six patients was 49.3 years, and their chief com plaints were persis(ent mucid or watery discharge and intermittent vaginal spotting, The clinical im presaion was carcioma of The uterine cervix in faur out, of six cases. All except one were pathologically confirmed by initia1 biupey. two cases by colposcopic biopsies, two by cone biopsies, one by cone biopsy after suggested AM in calposcopic hiopsy. One case was incidentally found from hysterectnmised speeimen, which waas suspected as adennmyosis. On gross examination, the cervix usualty appeared either firm or indurated with thickening af the wall excepl one which was presented es a fungnting mass. The characteristic histologic feetures were ext,ensive arborizing endeervical glands with marked variation in size and shape, and the glands lined by mucin conyaining columnar epithelial cells with basal bland looking nuclei but with occasional cytologic atypia and rare mitose. The nenplasi.ic glands were characterized by deep stronml invasion be yond normal enddcervical glands, assosiated with loose edematous periglandular desmaplastic stromal reaction in moat cases. Immunohistochemical stainnings for carcinoembryonie antigen (CEA) revealed ey- toplasmic positivity in five cases. The clinical stage for all exeept one incidental case were : four Ib and one II b. In three cases, the radical hysterectomy with unilateral salpingooophorectomy plus dissection of bilateral pelvic and paraaortic lymph nodes was performed, and in one case radiotherapy was done prior to radical hysterectomy with bilateral salpingoophorectomy plus the dissection of left pelvic lymph nodes followed by chemotherapy. Total abdominal hysterectomy with bilateral salpingooophorectomy plus Burch's operation followed by radiation therapy was performed in on case. The remaining one case was treated with radiation therapy. Metastasis to the left obturator lymph node was discovered in one case with state IIb, and the patient expired 29 months after the radiotherapy. The remaining five cases are being carefully followed up. From our experience, we conclude that the early diagnosis of AM can be made based on comprehensive analysis concerning the clinical features, histopathological and immunohistochemical findings. The early diagnosis and proper therapy can lead to the better prognosis.
Adenocarcinoma ; Adenoma* ; Biopsy ; Cervix Uteri* ; Drug Therapy ; Early Diagnosis ; Epithelial Cells ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Metrorrhagia ; Mucins ; Neoplasm Metastasis ; Prognosis ; Radiotherapy

To evaluate the possibility of the newly developed highly porous glass ceramics as a space-filler in the cavitary bone defect, we made the opening sized 1 × 0.5 cm on the medial aspect of the right proximal tibia of nine rabbits. We impacted the highly porous glass ceramics firmly to the medullary cavity of rabbit tibia through the opening. Each three were sacrificed at 4th, 8th, and 12th week and analyze in vivo reaction of the glass ceramics in rabbit tibia with radiological and histological methods. On radiological examination, radiolucent line was seen around impacted glass ceramics at 4th week, but this radiolucent line was obliterated gradually to 12th week. On histological examination, new bone formation with osteoblast was appeared at 4th week without foreign body reactions. At 8th week, newly formed bone infiltrated into the porous space between glass ceramics particles was noticed, and the surface of glass ceramics was tightly bound by newly formed bone with osteoblastic rim and mature bone, At 12th week, the amount of newly formed mature bone increased, though there was on evidence of resorption of glass ceramics particle. So, we suggest that the highly porous glass ceramics is one of the possible artificial bone graft substitutes, especially as a space-filler.
Ceramics ; Foreign Bodies ; Glass ; Osteoblasts ; Osteogenesis ; Rabbits ; Tibia ; Transplants

PURPOSE: Intrarenal reflux(IRR) is backflow of urine from the renal pelvis into the collecting ducts. IRR is the main cause of renal injury in children with vesicoureteral reflux (VUR) which leads to renal scars, hypertension, proteinuria, and chronic renal failure. The purpose of our study was to investigate the characteristics of intrarenal reflux. METHODS: We retrospectively reviewed the medical records of 80 patients who were diagnosed as having grades of III-V VUR from Jan. 2004 to Dec. 2006 in the department of pediatrics in Ajou University Hospital. The patients were divided into two groups according to the presence of IRR on voiding cystoureterogram and compared to each other for the possible factors associated with intrarenal reflux. RESULTS: Among 80 VUR patients, IRR(+) group comprised 17(21.3%) patients and 27 renal units(23.2%) and revealed younger age, higher grade of VUR, and more proteinuria compared to IRR(-) group. There were no significant difference in gender, laboratory findings and the rate of resolution in VUR or defects on renal scan between two groups. Also, intrarenal reflux mostly corresponded to the same site of photon defects on DMSA scan. CONCLUSION: We suggest that intrarenal reflux tends to be associated with younger age, higher grade of reflux, more proteinuria with no difference in resolution rate of VUR when compared to the VUR patients without IRR. From this study, we were able to understand the characteristics of intrarenal reflux in children with urinary tract infection.
Child ; Cicatrix ; Humans ; Hypertension ; Kidney Failure, Chronic ; Kidney Pelvis ; Medical Records ; Pediatrics ; Proteinuria ; Receptor, Insulin ; Retrospective Studies ; Succimer ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

No abstract available.
Hernia, Inguinal* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Radionuclide Imaging*

No abstract available.
Humans ; Renal Insufficiency, Chronic* ; Rhabdomyolysis*

In order to identify the correlations between clinical results and quantitative data of gait analysis, we analyzed the results of 20 cases of total knee joint replacement arthroplasty in 15 patients with degenerative arthritis. We also evaluated the gait analysis of ten age-matched healthy candidates as a control group. Mean follow-up periods were 30 months. Clinical results included post-operative HSS (Hospital for Special Surgery) knee rating scores and the changes of the tibiofemoral angles. The three dimensional gait analysis included clinical assessment, video-taping, three dimensional kinematics and kinetics. The three dimensional kinematics were obtained using a 5 camera VICON system, and the three dimensional kinetic data was collected using two AMTI force plates. There was no statistical difference in linear parameters between the patient and control group. In patients group, however, double support time decreased as the HSS score increased, and range of knee motion and maximum knee flexion increased in accordance with the increase of pain score. Kinematic data of the patients group revealed that some parameters, such as knee flexion during loading response, knee flexion in swing phase, and knee varus during swing phase, were decreased. On the other hand, internal rotation of the knee from initial contact to initial swing was increased when compared with that of control group. There was no significant correlation between the degrees of tibiofemoral angle and coronal plane moment in the patients group. In three cases which showed mild varus instability post-operatively, knee flexion during loading response decreased and valgus moment in midstance increased as compared with the cases without instability. We believe that three dimensional gait analysis will be a good modality for evaluation of the results after total knee arthroplasty. With further accumulation of long term. follow-up data of gait analysis, we might be able to predict the long term results of total knee arthroplasty including possibility of loosening.
Arthroplasty* ; Arthroplasty, Replacement ; Biomechanical Phenomena ; Follow-Up Studies ; Gait* ; Hand ; Humans ; Kinetics ; Knee Joint ; Knee* ; Osteoarthritis

Spinal fixation using pedicle screws has recently been the focus of increased attention, but the adequate size of pedicle screw and maximum percentage fill as related to the pedicle diameter and are not well known. The objects of this study were to determine the ideal ratio among pedicle, drill and screw diameter, and to determine the maximum percentage fill of the screw without significant decrease of pull-out strength. The materials used for the experiments were 376 thoracic pedicles obtained from the 38 young pigs, and the diameters of pedicles ranged from 3.0 to 8.5mm. After 40% to 100% drilling as compared to pedicle diameter, screws were inserted carefully, and measurements were taken of the outer pedicle changes and pull-out strengths, and adequate drill and screw sizes as related to the diameters of given pedicles were determined. It was found that pull-out strength was the strongest after 60% drill, and the larger the drill diameter, the smaller the holding power, and the larger the screw diameter, the greater the holding power. Maximum pull-out strength was seen at 80-90% fill with 60% drill. After sequentially drilling each pedicle with increasingly larger drill bits, larger screws could be inserted with pedicle changes such as expansion, cutout, split fracture, and comminuted fracture. after larger drilling up to 100%, pedicle screws with diameters smaller than 115% of measured pedicle diameters could be safly inserted without fracture and significant decrease of pull-out strength. It is concluded that effective percentages of drill and screw diameters to the pedicle diameter are 60% and 80-90% respectively, and pedicle screw up to 115% of measured pedicle diameter can be safely inserted into pedicle without significant decrease of pull-out strength. It is thought that fresh pedicle has elasticity and larger screw can be inserted to the pedicle with strong holding after larger drilling.
Elasticity ; Fractures, Comminuted ; Pedicle Screws ; Swine

PURPOSE: To investigate transitional changes in refractive error distributions in a pediatric population using the Korean National Health and Nutrition Examination Survey (KNHANES) data. METHODS: We investigated 7,181 subjects from the 4th and 5th (2008–2012) KNHANES and 1,225 subjects from the 7th (2016) KNHANES; all subjects were 5 to 18 years of age. We used the average spherical equivalent (SE) of both eyes calculated with noncycloplegic refractive errors measured via autorefractor. We determined SE percentiles by age in order from hyperopia to myopia. We acquired the mean SE by age. We investigated the proportions of subjects with mild, moderate, and severe refractive errors by age. RESULTS: Mean refractive errors were −1.73 ± 2.16 diopters in subjects in the 4th and 5th KNHANES and −1.66 ± 2.21 diopters in subjects in the 7th KNHANES; these were not significantly different between the two groups (p = 0.071). Mean refractive errors were more myopic in subjects in the 4th and 5th than in subjects in the 7th KNHANES only at 8 and 9 years of age (p = 0.018, p = 0.026). The distribution of percentiles by age was similar between the two groups. The respective proportions of hyperopia, emmetropia, and myopia were 6.2%, 27.6%, and 66.2% in subjects in the 4th and 5th survey, and 7.3%, 29.7% and 63.0% in subjects in the 7th survey. There was no significant difference in refractive error proportion between the 2 groups (p = 0.326). CONCLUSIONS There was no definite transitional change of refractive error distributions between the two KNHANES groups. However, additional periodic surveys are needed to confirm this hypothesis.

We evaluated the antihypertensive effect of amlodipine, a calcium channel bloker, in 35 cases of essential hypertention. After 12 weeks' administration(5~10mg q.d.), the following results were obtained : 1) The systoloic and diastolic blood pressure were decreased significantly(170.3+/-12.2mmHg vs 143.7+/-13.0mmHg p<0.01 and 104.7+/-5.9mmHg vs 87.8+/-6.5mmHg, p<0.01, respectively) but the heart rate was independant of amlodipine administration. 2) The systolic blood pressure was lowered by 20mmHg or more in 26(76.5%) of 34 patients and the diastolic pressure was lowered by 10mmHg or more in 26(76.5%) of 34 patients at 12 weeks after amlodipine administration. 3) The adverse effects of amlodipine were dizziness in 5, edema in 5, indigestion in 3, constipation in 2, headache, flushing, insomnia in 1 patient respectively and only one of them discontinued amlodipine administration due to severs facial flushing and skin eruption.
Amlodipine* ; Blood Pressure ; Calcium Channels ; Constipation ; Dizziness ; Dyspepsia ; Edema ; Flushing ; Headache ; Heart Rate ; Humans ; Skin ; Sleep Initiation and Maintenance Disorders